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Application for Supplemental Security Income--MISSICS with Signature Proxy
Application for Supplemental Security Income (SSI)
OMB: 0960-0229
IC ID: 44923
OMB.report
SSA
OMB 0960-0229
ICR 200902-0960-017
IC 44923
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0229 can be found here:
2021-12-03 - Revision of a currently approved collection
2021-05-07 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form SSA-8000
Application for Supplemental Security Income--MISSICS with Signature Proxy
Form
SSA-8000 Application for Supplemental Security Income (SSI)--MSSI
MSSICS Screens.pdf
Form
SSA-8000 Application for Supplemental Security Income (SSI)--New
MSSICS Screen Mock-up -- Additional Screen for Direct Express.doc
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Application for Supplemental Security Income--MISSICS with Signature Proxy
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
20 CFR 416.207
20 CFR 416.305-.335
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
SSA-8000
Application for Supplemental Security Income (SSI)--MSSICS Screens
MSSICS Screens.pdf
Yes
Yes
Fillable Fileable Signable
Form
SSA-8000
Application for Supplemental Security Income (SSI)--New Screen for Direct Express
MSSICS Screen Mock-up -- Additional Screen for Direct Express.doc
Yes
Yes
Fillable Fileable Signable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,117,515
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,117,515
0
0
0
0
1,117,515
Annual IC Time Burden (Hours)
651,884
0
0
0
0
651,884
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.